Cognitive Behavioral Strategies

Lynne S. Gots, Ph.D.
Licensed Psychologist

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How to Get through Trying Times without Losing Your Mind

By Lynne Gots, posted on January 22nd, 2017.

As a cognitive-behavioral psychologist, I teach people how to handle distress by changing the thinking patterns and behaviors that negatively affect their emotional well-being. The inauguration of the new President has stirred up strong feelings for many on both sides. So it seems fitting to offer some coping advice for weathering this highly polarized and emotionally charged political climate.

First, I’d like to correct one misconception. Contrary to what many journalists reported during the campaign and following the election, I haven’t seen an uptick in referrals due to anxiety about the new administration. My practice is just as busy now as it’s always been, but no one has contacted me specifically because they can’t deal with the current state of affairs. To be sure, discussions about politics and heated emotional reactions have come up frequently during recent therapy sessions–I work in DC, after all, and see many lobbyists, lawyers, Hill staffers, and Federal employees from both ends of the political spectrum. But anxiety, for those who are prone to it, tends to attach itself to whatever happens to be in the headlines of the moment. Today it’s the roiling political climate; at other times it’s been Anthrax or West Nile Virus or bedbugs. The important point to remember, as I’ve noted before, is that the content of anxiety is irrelevant in learning how to manage it.

1. Practice selective avoidance

Although I don’t typically encourage avoidance as a way to reduce anxiety, I do advise managing triggers strategically. So if you know reading the Comments section of a blog post or news article will send your blood pressure through the roof, skip it. Likewise with Facebook and Twitter. You already know what the people you follow think, so you won’t be missing anything important.

2. Limit the time you spend reading the news

For any compulsive behavior–and checking the news for a media junkie can become as uncontrollable as washing for a germophobe–coming up with a reasonable schedule can help dampen the urge to check and keep your emotional reactions from coloring your entire day. If this is a problem for you, try limiting the number of sites you read to two or three major news outlets; don’t go on your phone the moment you wake up; decide only to look, say, after breakfast, lunch, and dinner– and never before bed.

3. Challenge your thoughts 

A standard CBT technique is to identify cognitive distortions contributing to intense, negative emotions such as anger, anxiety, and depression. Two common distortions, labeling and overgeneralization, may lead to anger towards those whose political beliefs differ from our own. In a Pew Research Center Poll, Republicans attributed these qualities, ranked from highest to lowest, to Democrats: close-minded, immoral, lazy, dishonest, unintelligent. The view of Democrats towards Republicans differed only in the order of the ranking: close-minded, dishonest, immoral, unintelligent, lazy. Clearly, such sweeping generalizations and negative labels create acrimony and even hatred of The Other.

4. Practice mindfulness

Railing against what should or shouldn’t be happening can make a difficult situation unbearable. As a Buddhist saying goes, “If you get struck by an arrow, do you then shoot another arrow into yourself?” The Second Arrow–our reaction to a bad event–only adds suffering to the pain. We can cope more effectively if we adopt an attitude of acceptance. Keep in mind that acceptance doesn’t mean liking the status quo or giving up. It simply involves seeing things for how they are without judgement.  Dialing down our emotional reactivity allows us then to make more clear-headed decisions about the course of action we want to take.

5. Cultivate compassion 

Attempting to understand another’s point of view, even if you never arrive at any common ground, can help you feel less angry. Berkeley sociologist Arlie Hochschild, a Progressive academic who couldn’t be more different from the residents of St. Charles, Louisiana, where she embedded herself during a 5-year study, scaled what she calls “the empathy wall” to understand the economic and social forces that led them to embrace the Tea Party. Over time she came to see them as people rather than stereotypes. They, in turn, came to accept her as a human being rather than dismissing her as a “West Coast liberal.” In the end, they developed a mutual respect for each other even though their political positions never changed.

Emotional resilience requires the ability to see moods as transient, like the weather. We can apply the same approach to preserving our sanity in today’s stormy political climate. Lay in ample reserves of acceptance, empathy, compassion. Take constructive action. Batten down the hatches. And wait for the hurricane to pass.




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Why You Shouldn’t Look to the Internet to Answer Your Questions about Distressing Thoughts

By Lynne Gots, posted on April 17th, 2016.

 

If you struggle with OCD, you’ve probably searched online for answers to the questions that consume you. Finding virtual communities of like-minded sufferers can make you feel less isolated, especially if your worries involve the very common but shameful-to-admit obsessions such as doubts about sexuality and thoughts about violence. But extensive researching and comparing yourself to others with similar symptoms—even if your efforts seem to give you some relief—can make your OCD much worse in the long run.

Here’s why the Internet can be problematic for someone with OCD:

1) Much of the information you’ll find is wrong.

This is hardly groundbreaking news, but I can’t emphasize it too much. One of my patients recently told me about a blog (which I won’t name) written by someone with OCD. Even under my careful professional scrutiny, it looked pretty helpful at first glance. There were some informative discussions about the symptoms of OCD and the importance of seeking treatment from an experienced cognitive-behavioral therapist.

But then I scrolled to a post the author had clearly meant to be reassuring (if you’ve been under my tutelage for any time at all, you’ll know where I’m going with this) but was completely off base in its message.

She had done an “informal survey” of 4 of her friends, two identified as gay and two as straight but with the type of OCD causing them to wonder if they really might be gay. She proceeded to list the differences she found between them: how certain they were about their attraction to individuals of the same/opposite sex, when they first “knew” (in the case of the two gay respondents), whether they sometimes found individuals of the same/opposite sex attractive in the absence of sexual feelings towards them, and so on. And then she went on to draw some conclusions clearly designed to be comforting to people with OCD doubting their sexual identity.

2) Advice, however well intended, can reinforce compulsions.

Aside from the obviously unscientific nature of her “study” (a comically small and biased sample, for starters), her attempt to ease the suffering of OCD doubters was misguided. It provided some with relief and had exactly the opposite effect for others, as evidenced by the varied responses to the post. Many even questioned whether they actually had OCD because they weren’t exactly like the people she described.

That’s what OCD does! It makes you wonder and doubt, dragging you down the rabbit hole of uncertainty. And the well-meaning blogger (who claims to be “cured” of her own OCD) unwittingly served as its accomplice by encouraging others to seek reassurance with “facts” and comparisons—thereby perpetuating the “checking compulsions” her followers had certainly already been relying on to make themselves feel less anxious.

So if you’re struggling with distressing thoughts and find yourself tempted to Google for answers, I recommend you consult one site and one site only (or none at all, if you won’t be able to keep yourself from looking further): the International OCD Foundation (iocdf.org). You’ll find credible information and a referral database of reputable professionals skilled in treating OCD.

 

 

 

 

 

 

 

 

 




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Could Too Much Clean Eating be Bad for Your Mind?

By Lynne Gots, posted on April 3rd, 2016.

You can’t walk past the magazines in the supermarket, go out to dinner with friends or check your Instagram feed or Facebook these days without being bombarded by diets aimed to cure whatever ails you. All these plans—whether they’re gluten-free, Paleo, organic, vegetarian, or vegan—involve eliminating foods purported to cause a host of health problems.

One such popular program goes so far as to promise it will “change your life in 30 days,” offering testimonials (which, I might point out, do not count as scientific evidence) from participants who claim it has cured them of a long list of so-called “lifestyle-related diseases.” These include but are not limited to: high blood pressure and high cholesterol, diabetes (both Type 1 and Type 2), asthma, allergies, infertility, depression, bipolar disorder, arthritis, ADHD, and inflammatory bowel disease. The psychiatric literature, last I heard, doesn’t consider depression, bipolar disorder, or ADHD lifestyle-related diseases. That’s a topic for another post. But for now, I’ll get back to the subject at hand.

Even the widespread trend towards “clean eating”—whose proponents like to think of it not as a diet, but as a lifestyle choice or even a movement—comes with rules. Eat lots of fruits and vegetables. Eat only “whole” meats, preferably organic, whose sources you know. Eat only whole grains. Avoid all processed and refined foods (e.g., sugar, baked goods, white flour, white rice, empty-caloric junk foods). Avoid saturated and trans-fats. Drink at least 8 cups of water a day.

“What’s wrong with trying to follow a healthy eating plan?” you might ask. And my answer would be, “Nothing. Usually.”

But if you tend to become fixated on avoiding specific foods because you’re excessively concerned about controlling your weight or think they might cause cancer or other diseases, be careful. Even a so-called “non-diet” like the clean-eating approach can lead to emotional struggles for perfectionistic people prone to eating disorders or health anxiety.

Any time perfectionists impose all-or-nothing restrictions on themselves, they run the risk of getting upset and ditching the diet altogether if they think they’ve broken the rules. It doesn’t even have to constitute a major transgression, such as picking up a Big Mac, fries, and large Coke from the MacDonald’s drive-through on the way home from work. If you’re evaluating your food choices from the perspective of a black-and-white mentality (and comparing them with the colorful Instagram images of the kale smoothies, grain bowls, and lush farmers market produce others appear to be eating), you could easily beat yourself up for popping a handful of M&Ms at the movies or having white rice with your homemade, clean Pad Thai. Then you might decide you’ve blown it for the day (or week), and let loose with a full-blown binge. You’ll feel guilty, vow to atone and never stray again, and set yourself up for the next self-punishing cycle of deprivation and excess.

Let me make my position clear before the critics jump on me for questioning sound nutritional practices. I’m not suggesting you go overboard with the junk food and the trans-fats. I’m not urging you to forego whole grains in favor of Wonder Bread. I’m not recommending you trade your bottled water for a Big Gulp. I’m not even telling you the clean-eating lifestyle is bad. (Though I might be telling you not to drink the diet Kool-Aid du jour without seriously evaluating its claims from an evidence-based perspective).

But when food—no matter how nutritionally pure, unadulterated, and good for your body it may be—becomes a source of internal conflict, guilt and anxiety, you might want to think about what it’s doing to your mind.

As with most things in life, moderation and flexibility are the keys to emotional wellbeing. Your mindset about eating is just as important for your health as the foods you eat. Sadly, Instagram can’t capture that.

 

 

 




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This blog is intended solely for the purpose of entertainment and education. All remarks are meant as general information and should not be taken as personal diagnostic or therapeutic advice. If you choose to comment on a post, please do not include any information that could identify you as a patient or potential patient. Also, please refrain from making any testimonials about me or my practice, as my professional code of ethics does not permit me to publish such statements. Comments that I deem inappropriate for this forum will not be published.

Contact Dr. Gots

202-331-1566

2440 M Street, NW
Suite 710
Washington, DC 20037

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If you don't receive a response to an email from Dr. Gots in 48 hours, please call the office and leave a voicemail message.

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